1989, 01-17 Permit App: 89000112 Furnace t
MECHANICAL PERMIT-APPLICATION•WORKSHEET
PLEASE.PRINT AND COMPLETE ONLY. Hy, SPA4(,RTS OF THE.FORM YOU UNDERSTAND(
. f Project 0 / I/)
Owner's Name Last First. _ MI I
L L w 0(z.7,4�1.:: •L, z '
Project Address(Street Name&Number).'
city State 8ubdlvldon Plat Name
_ SPS C L1/4)Ar-
A • coin ,
Assessors Parcel M o . Blodt' Ptat I
/ 5 - /1 '' .... .
2.--
Applicant ,
pplicant Address. r.
..FL.— .
City State 1 . p`9, .?"4-7.--P ‘ -Ptwne I.Z-Y 6 7 g
. ,
.1.....,,,!. Business Phone
Contractor '•
Addres,� i.) 9-/��
Phone
y State v V � ,S---35----- /7//
• Business Phone
d
Contact RU S LEst /J D F ..3License M"if,�/VE/f -37.( �/� ii
Dasc•lbe Work 'F E-.
6 L
t r C 0 L L- s eAle .,,
Pans EvaporatiiveeCooler Hoods Electric Furnace/ducts Miscellaneous
' Gat Gas Water Htr. Solid Fuel/Wood Stove
Dryer Range L• g`',. .
0.10,000 CFM
10,000+CFM
Air Handling Units
r
aelrlgeratlon Systema/ •1-100M 101-500M 501-1,000M
Meat Pumps(BTU)
1,001.1750M , Over 1750M
O-3H P 3-15H P 1 S-30H P 30-50H P 50+HP
Compressor
1-S Out1sU • 6+Outlets
Gas Piping
1-1;10,C0001-U •• • •.'' • ' ' ' 1A'_.,�O0+BTl t
Gas Fired Heating System ? Q Q Q I `
':,2 • .
. I certify that the above information as submitted by''me is-�true and.correct and further, agree that all pro-
visions of laws and ordinances.governing this:type of-work; Including inspection requirements, will be com-
plied with whether specified herein•or not: The granting:of a.permit does not presume to give authority to
violate or cancel the provisions of any state of,'local laws regulating construction or the performance of
Construction.
•
SIGNATURE OFfit. APPLICATION 1 — t �� 't
OWNER OR DATE
,